Am I Eligible For the NDIS?

Am I eligible for the NDIS?

There are a number of factors which determine whether you are eligible for support under the NDIS when it rolls out in your area.

You may be eligible to receive an individual support plan if you are:
-Under 65 years of age
-An Australia citizen, a permanent resident, or New Zealand citizen who is a Protected Special Category Visa holder
-Have a permanent and/or significant disability that impacts your everyday living and requires help from others to do things, equipment or assistive technology.

For further information on eligibility, please visit the NDIS access checklist: www.ndis.gov.au/ndis-access-checklist

If you are not currently receiving disability services you may still be eligible for the NDIS. You will need to contact the NDIS directly to complete an access request form. You do not need a referral. Visit www.ndis.gov.au or call 1800 800 110.

National Disability Insurance Scheme (NDIS)

The National Disability Insurance Scheme (NDIS) is an Australia wide scheme that will support people with a permanent and significant disability that affects their ability to take part in everyday activities. The NDIS will give people with disability more choice and control over how, when and where supports are received, and provides certainty that they will receive the support they need over their lifetime.

If you are eligible for the NDIS you will receive funding on an annual basis to purchase reasonable and necessary supports that will help people with disability to pursue their goals, achieve increased independence and help them to participate in their community both socially and economically. The support can include education, equipment, health, well-being, employment and social participation.

The NDIS launched in July 2013 at a series of trial sites around Australia. In NSW, the trial site is the Hunter Region. The NDIS is a very significant change from how disability support is currently provided and “trial sites” allow the government to make sure the system works well and is sustainable in the long term. Extensive consultation is being held with participants, families and carers throughout the trial period. The full national roll out of the NDIS is due to be completed by 2018/2019.

From July, 2016, the NDIS will be rolled out in NSW and by July 2018, all eligible NSW residents will have access to funding. At this stage no exact timetable is available.

If you are aged 65 or over you are not eligible to participate in the NDIS. The new Federal Government “Living Longer, Living Better” program of aged care will provide additional care and support for living at home, additional help from carers and self directed funding. For more information go to: www.myagedcare.gov.au

The National Disability Insurance Agency (NDIA) has been formed to oversee the implementation of the NDIS. The NDIA is responsible for determining eligibility for the NDIS and undertaking planning with people with disability. Staff will assist participants to access the agreed supports identified in their plan and facilitate payment of providers if required.

If you are currently receiving funding through Ageing Disability and Home Care (ADHC) in NSW you may be contacted when the NDIS is available in your area, however it is always important to check, and if you have any concerns contact the NDIS directly.www.ndis.gov.au.

Access and Eligibility

From July, 2016 the NDIS will be gradually rolled out across NSW. If you or your family member live in an area where the NDIS is available and you meet the eligibility criteria you will be able to access the NDIS.

The NDIS will provide funding to people who are 0-64 years of age, who have a significant or permanent disability and who need help with everyday activities. This includes people whose disability is attributed to intellectual, cognitive, neurological, sensory, or physical impairment, or a psychiatric condition. The NDIS website has a tool called My Access Checker This application provides a series of questions to help people understand whether they may be able to access assistance under the NDIS. It might take 10-20 minutes to complete.

People who are not eligible for funding under the NDIS can still get advice and information from the organisation. For people who apply and are not successful there is a review and appeals process. Go to www.ndis.gov.au for more information on how to appeal a decision by the NDIS.

Your pathway for accessing support depends on your situation, your goals and choices. As a first step, complete the My Access Checker application online www.ndis.gov.au/my-access-checker If you are eligible and are in an area where the NDIS is operating, contact the National Disability Insurance Agency (NDIA) and arrange an appointment. You will then work with the NDIA to;

Confirm eligibility – at your first appointment, you will meet with a planner to confirm your eligibility.

Develop an individual plan – once your eligibility is confirmed you will meet with a planner to discuss your goals and aspirations for the life you want to live and the reasonable and necessary support you need to achieve this.

Choose your supports – if you wish, a local area co-ordinator can help you choose your supports based on your individual plan, or you can manage this yourself. This can include choosing your support providers.

Review your plan – From time-to-time, your planner will contact you to check whether your plan is still helping you work towards your goals.

Yes you will, but you will not have to constantly be reassessed for eligibility. The NDIA may also accept a current written assessment of your or your loved one’s disability. The initial assessment will determine eligibility and the level of support you require. The plan will be reassessed annually to ensure maximum benefit for the participant.

No, the assessment process is managed by the NDIA, but AFFORD is able to work with you prior to the assessment to help achieve the best possible outcomes for the person with disability.

Services and Support

The NDIS will fund “reasonable and necessary” supports that;

  • Support people with disability to pursue their goals and maximise their independence, and
  • Support people with disability to live independently and to be included in the community as fully participating citizens, and
  • Develop and support the capacity of people with disability to undertake activities that enable them to participate in the community and in employment.
  • The supports must assist the person with disability to pursue their goals, objectives and aspirations, encourage social and economic participation, represent value for money and be effective and beneficial for the participant. The NDIS will take into account existing supports provided through the state or Commonwealth and these existing supports may form the basis of the new plan. It has also been agreed that no person should be disadvantaged by the transition to the NDIS. Supports provided can cover areas such as Personal Care, Community Access, Transport, Interpreting and Translating and Employment. The funding covers services, supports and equipment.

Above all the NDIS has been designed to provide significant choice and control to people with disability.

NDIA staff will make decisions based on the National Disability Insurance Scheme Act 2013 (NDIS Act) and the rules made under the NDIS Act. When NDIA staff members make decisions about which supports would be reasonable and necessary for a particular participant, they refer to the particular operational guideline that relates to each specific support. In order to be considered reasonable and necessary, a support must:

  • be related to the participant’s disability
  • not include day-to-day living costs that are not related to a participant’s disability support needs
  • be likely to be effective and beneficial to the participant, and
  • take into account informal supports given to participants by families, carers,
  • networks, and the community.

Supports that will not be funded include those:which may cause harm to the person or others. that are not related to the person’s disability. that duplicate supports received through other funding. are really day-to-day living expenses (rent, food, household bills etc.) are related to income replacement. are medical or clinical services.

If you or your loved one is currently receiving funding from ADHC in NSW this will continue until the NDIS is available in your area. When the NDIS becomes available in your area, providing you are aged between 0 and 64 years of age, a plan will be developed to best meet your needs and you will transition to NDIS funding.

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